Counting the Costs: how are the costs of action and inaction best framed to drive effective change?

25 January 2021


Reported by Samuel Ward, CSaP Policy Intern and Kate McNeil, CSaP Communications Coordinator

What are the key actions needed in order to have a healthier, fairer and sustainable future? What metrics do we currently use to measure the costs and benefits of action and inaction?

In the first seminar of the 2021 Christ's College Climate Series, we explored how people can influence change in societal and institutional structures, and addressed pressing issues in climate and population health. Throughout the seminar, Professor Dame Theresa Marteau, Professor Sir Michael Marmot, and Professor Diane Coyle explored how to frame action and inaction on issues such as public health and climate change, and examined how to increase the likelihood that effective action will be taken.

You can listen to the discussion here:

Building Back Fairer:

Reflecting on the state of the United Kingdom prior to the onset of the covid-19 pandemic, Professor Sir Michael Marmot has argued that “we do not want to go back to the status quo.” The UK was already experiencing a slowdown in improvement in life expectancy prior to the pandemic, which was combined by increasing inequality throughout the country. These inequalities, which were linked to austerity, have been exacerbated by the pandemic, while inequalities in mortality rates from covid-19 can be mapped onto inequalities in health more generally. If we want to deal with the health inequalities brought to light by the pandemic, Sir Michael stressed that we must also respond to the inequalities in our society more broadly. He emphasised that building back fairer must involve putting health equity and wellbeing at the heart of all government policy. Moreover, he suggested that we need to create the conditions for people to live healthier lives through actions in a wide range of domains including early childhood education, employment, and the creation of healthy communities. This work will necessitate the involvement of a range of actors, including local and national government, and civil society.

Building Metrics for Better Public Policy:

"As an economist, you're trained in a very technocratic way. You download your data without really questioning how that data got classified, how it got collected, and what it means when it's translated into outcomes of people's lives," reflected the Bennett Institute's Professor Diane Coyle. She suggests that as we work to build better policies which improve people's lives, we need to work to encourage economists and civil servants to think in different ways, and to tackle the diversity problem in the field of economics. She believes we need to think beyond the numbers - instead working to understand what the data represents about people's lived experiences.

The ONS has opened up a consultation on a health index which combines several measures to produce a single metric for measuring national health, and Dame Theresa questioned whether a similar cross-sectoral tool could be used to create a unified metric which combines health and sustainability. Here, Professor Coyle emphasised that such a metric would have to be interdisciplinary. She noted that such a metric could be a powerful tool for persuading policymakers that something needs to be done, while cautioning that a single index would result in a loss of nuance. Sir Michael echoed this caution, suggesting that using too coarse an index may miss interactions between measurements, while obscuring the relationships between causes and effects. He also noted that to develop equitable policies, we need both measurements and the accompanying morals.

During the first lockdown, Sir Michael suggests that we learned to recognize who keeps our society functioning, and what we owe each other. Both Sir Michael and Professor Coyle believe that we are at a moment of change, and that the path we need to take to build a more equitable society is clear. Realizing this change will require not only intellectual frameworks for policies, but the building of momentum and political will through people pressure.

The 2021 Christ’s College Climate Seminar Series focuses on achieving change for population and planetary health post pandemic. This year's series is hosted in partnership with Christ's College and the Lancet-Chatham House Commission on Improving Population Health Post COVID-19. Throughout the series, we will be exploring how three major threats to population and planetary health— infectious diseases, non-communicable disease, and climate and environmental emergencies are intimately intertwined, and how synergistic actions across these areas have the potential to promote transformative change. You can learn more and register to attend upcoming seminars in this series here.

Professor Dame Diane Coyle

Department of Politics and International Studies (POLIS), University of Cambridge

Professor Sir Michael Marmot

University College London (UCL)

Professor Dame Theresa Marteau

Behaviour and Health Research Unit (BHRU), University of Cambridge

Samuel Ward

University of York